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EASIX-1year and late mortality after allogeneic stem cell transplantation

Abstract - Patients with hematological malignancies who survive the first year after allogeneic stem cell transplantation (allo-SCT) without relapse have a substantial risk of nonrelapse mortality (NRM) and missing predictive markers. The Endothelial Activation and Stress Index (EASIX) p...

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Hauptverfasser: Kordelas, Lambros (VerfasserIn) , Terzer, Tobias (VerfasserIn) , Gooley, Ted (VerfasserIn) , Davis, Chris (VerfasserIn) , Sandmaier, Brenda M. (VerfasserIn) , Sorror, Mohamed (VerfasserIn) , Penack, Olaf (VerfasserIn) , Schaeper, Nigel D. E. (VerfasserIn) , Blau, Igor-Wolfgang (VerfasserIn) , Beelen, Dietrich W. (VerfasserIn) , Radujković, Aleksandar (VerfasserIn) , Dreger, Peter (VerfasserIn) , Luft, Thomas (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: September 15, 2023
In: Blood advances
Year: 2023, Jahrgang: 7, Heft: 18, Pages: 5374-5381
ISSN:2473-9537
DOI:10.1182/bloodadvances.2022008617
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1182/bloodadvances.2022008617
Verlag, lizenzpflichtig, Volltext: https://ashpublications.org/bloodadvances/article/7/18/5374/496948/EASIX-1year-and-late-mortality-after-allogeneic
Volltext
Verfasserangaben:Lambros Kordelas, Tobias Terzer, Ted Gooley, Chris Davis, Brenda M. Sandmaier, Mohamed Sorror, Olaf Penack, Nigel D.E. Schaeper, Igor W. Blau, Dietrich Beelen, Aleksandar Radujkovic, Peter Dreger, and Thomas Luft
Beschreibung
Zusammenfassung:Abstract - Patients with hematological malignancies who survive the first year after allogeneic stem cell transplantation (allo-SCT) without relapse have a substantial risk of nonrelapse mortality (NRM) and missing predictive markers. The Endothelial Activation and Stress Index (EASIX) predicts endothelial complications and NRM early after allo-SCT. We hypothesized that EASIX assessed 1 year after allo-SCT in survivors who were disease free may predict late NRM. Survivors who were relapse-free at 1 year after allo-SCT were retrospectively studied in 2 independent cohorts (training cohort, n = 610; merged validation cohort, n = 852). EASIX determined 1 year after allo-SCT correlated with the overall survival (OS), NRM, and relapse. Serum endothelial and inflammatory markers were measured in the training cohort and correlated with EASIX-1year, which predicted OS and NRM but not relapse risk in both the training and validation cohorts in univariable and multivariable Cox regression analyses. Brier score and c-index analyses validated the univariable EASIX effects. There was no significant interaction between EASIX-1year and incidence of chronic graft-versus-host disease (GVHD) on OS. EASIX-1year predicted the outcome irrespective of preexisting comorbidities. Principal causes of NRM in both training and validation cohorts were infections with and without GVHD as well as cardiovascular complications. EASIX-1year correlated with sCD141 and interleukin-18 but not with C-reactive protein, suppressor of tumorigenicity-2, angiopoietin-2, CXCL9, or CXCL8. To our knowledge, EASIX-1year is the first validated predictor of late overall and NRM. Patients who are high risk as defined by EASIX-1year might be considered for intensified surveillance and prophylactic measures.
Beschreibung:Gesehen am 08.01.2024
Beschreibung:Online Resource
ISSN:2473-9537
DOI:10.1182/bloodadvances.2022008617

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